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Biomechanical constraints remain major risk factors for low back pain: results from a prospective cohort study in French male employees

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Biomechanical constraints remain major risk factors for low back pain

Prospective study among French workers

RESULTS

RAMOND-ROQUIN A

1,2

, PETIT LE MANACH A

1

, BODIN J

1

, SERAZIN C

1

, PAROT E

1,3

, HA C

4

, ROQUELAURE Y

1,5

1Laboratory of Ergonomics and Epidemiology in Occupational Health, University of Angers ; 2Department of General Practice, University of Angers ;

3 Center of Clinical Research, University Hospital of Angers ; 4Institute of Health Surveillance, Saint-Maurice ; 5 Department of Occupational Health,

University of Angers aline.ramond@univ-angers.fr

METHODS

DISCUSSION & CONCLUSION

One in two adults suffer from LBP at least once a year1

Direct costs for chronic LBP :

~ 715 € per patient every 6 months2

Impact on occupational settings : LBP = the most frequent reason for sick leave3

Low back pain (LBP) in France : A major public health problem

OBJECTIVE Prospective modelling of the risk of LBP in the French male working population INTRODUCTION

2002 Random selection of workers by their occupational physician.

Men – 20 to 59 years old – Loire Valley region of West-Central France.

First self-administered questionnaire

Second self-administered questionnaire (sent to men included in the first survey)

Statistical analysis:

Multivariate and multi-step logistic modelling of the risk of LBP in the male workers.

Selection of statistically significant risk factors (p<0.05) and confounding factors.

21 risk factors : biomechanical organizational psychosocial individual

Binary outcome :

LBP during the last 7 days ? Design :

Cohort prospective study

2161

male workers (first self-administered questionnaire) Age, occupations and economic sectors ≈ regional distribution

1313

men (second self-administered questionnaire) Prevalence LBP during the last 7 days : 30%

Unreachable people (n=146 : death/unknown address) Unanswered people (n=702)

Study population :

Final multivariate model

(n=1255 due to missing data):

RISK FACTORS OR (IC 95)†

Frequent bending (more than 2 hours daily)

No Forward Sideways Both

1 1.45 (1.07-1.97) 1.78 (0.74-4.27) 2.13 (1.52-3.00) Driving industrial vehicles Never

Occasionally/Often

1 1.35 (1.00-1.81) Working more hours than

officially planned

No Yes

1 1.38 (1.05-1.81) Low support from

supervisors

No Yes

1 1.35 (1.02-1.79) Low skill discretion No

Yes

1 1.28 (0.95-1.72)

F ir st s u rv e y S e co n d s u rv e y

† Odds-ratios for LBP and confidence intervals at 95%

2002/2005

2007/2009

Prospective study ; diversified cohort of male workers ; numerous risk factors Useful and relevant to the development ofpublic health policyfor workers.

Current research on LBP focus on psychosocial factors.

However biomechanical constraints (frequent bending, driving industrial vehicles) remain major risk factors that deserve to be considered in primary prevention ! 2005

2007

2009

Ethical aspects :

Written consent from the workers - Authorization from the National Commission of Data Protection

REFERENCES

1Gourmelen J, Chastang JF, Ozguler A et al. Frequency of low back pain among men and women aged 30 to 64 years in France. Results of two national surveys. Ann Readapt Med Phys. 2007 Nov;50(8):640-4, 633-9

2Depont F, Hunsche E, Abouelfath A et al. Medical and non- medical direct costs of chronic low back pain in patients consulting primary care physicians in France. Fundam Clin Pharmacol. 2010 Feb;24(1):101-8.

3Caisse Nationale d’Assurance Maladie - Travailleurs Salariés.

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